From Oct. '17:

Narcissistic psychopathy, a.k.a malignant narcissism is a character defect that manifests, mainly, in a severely impaired or absent conscience and an insatiable drive for power, adulation and revenge. https://link.medium.com/knIbtRZ159 
Its other essential features are Machiavellianism — a tendency to deceive, manipulate and use people for one’s own gain; and sadism — a desire to inflict pain on others for one’s pleasure.
Narcissistic psychopathy is fixed (inflexible, unchangeable), permanent (won’t go away with time) and incurable. It is also inherently destructive.
This means that individuals affected with it, especially when in power, cannot be counted on doing the right and decent thing — on the contrary: they prove time and again that they live for destruction as it gives them a sense of power and pleasure.
Narcissistic psychopaths clamor for power and, if skilled and/or lucky enough, they achieve it. Once in power, they fully exhibit their pathology as they are no longer inhibited by the need to curb it to secure other people’s approval.
We call it decompensation, but it is actually the narcissistic psychopath coming into his own, unleashing the contents of his defective psyche on the world without any constraints.
Not having a conscience means that narcissistic psychopaths are incapable of experiencing empathy, guilt, shame, as well as understanding and respecting higher human values (compassion, truth, justice, equality, freedom).
Their insatiable & thus usually frustrated desire for power & adulation, & a sadistic, irrepressible need for revenge (this is the narcissist part of narcissistic psychopathy) manifest in acts of aggression, verbal and/or physical, or...
....in draconian, punitive political decisions if NPs happen to have such power. Often both.
Normal people may not understand this pathology. They look for normal explanations, which often assume, incorrectly, that a narcissistic psychopath may change; that “deep down” he suffers from repressed guilt and/or low self-esteem; etc.
There is nothing accidental about the destruction narcissistic psychopaths, especially in power, inflict on the world. Destruction is coded in their character defect.
They not only lack empathy and conscience, which makes them incapable of understanding human values, but they are driven to hurt and destroy everyone and everything that stands on their way to power and self-aggrandizement, and/or reminds them of their weaknesses.
It is not a question of IF a narcissistic psychopath in power will destroy his world, but how soon.

Narcissistic psychopathy is the most dangerous form of psychopathology known to humankind.
It is shared by all tyrants in human history, among other unsavory types. It is not mental illness, although this term is sometimes used to describe it, and there are some forms of mental illness, most notably paranoia, that are often associated with it.
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